1990, 12-12 Permit: 90006175 Sewer SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/application,state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same.All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not.I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
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SITE STREET= —
PERMIT USE= SEWER CONNECTION —
SEE NOTE
AREA= 00000000 F/A= F
'x' OF.
OWNER= SUNDERLAND, '}''. H PHONE=
STREET= 13007 E 12TH AVE
ADDRESS= SPOKANE WA 99216
BUILDING SETBACKS :. FRONT= NA LEfri = .NA Rif.;HT::: NA REAR= NA
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CONTRACTOR Oi R APPLICANT
L , sI :iNv FIELD
LOCATE • CONFIRM THE
ELEVATION As: n'T» . ti 1. ;} ^ i -
:
TO ANY OTHER
EXCAVATION :
TO LOCATE .*;; F: :::D 'at,iL ; w,-S : r` ?3E:.. WATER }'.
CALL BEFORE YOU DIG (456-a000)
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PPt"FR 1C}:P CALL R _ NEif . :
PRIOR TO COVER} tl•*t}:'yk*)t*b-tt*
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•
SPECIAL CONDITION CHECKLIST
Project
Address: _-- ��___---____-- — —_ _ Project# Use:
Dept: Date: Condition: !nit: Appr:
(in) (out)
Dept.of Bldgs.
Special Insp.Final Report
—__ Hydrant ( )
Lock Box — — — —
•
Engineer's_---. RID/CRP
Easements
Road Plans/Improvements
__ — — Bonds
•
Planning.___—_ ___— —_.__ _ Bonds..
•
•
Utilities- _ Double Plumbing• —__--
- — ULID — -- — —
•
•
Other__—_
""""""""--******"'"*•THIS SPACE FOR COMMERCIAL PLANS TRACKING,CERTIFICATE OF OCCUPANCY ONLY"--******•***“.****—***—
Date received for C/O processing: ___.__ _ Plans pulled for final processing:
Temporary C/O issued:______—____.__ —_-_. Certificate of Occupancy issued:.
Office file review by: _.__—__ . Date:
Filed insp finaled by:_— . Date:
Ninety days after 0/0 issuance:
Owner/contractor called regarding the return of plans: -- — Date:
Plans returned: Received by:
No response from owner/contractor-plans destroyed:_ —_____— —